Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $5,128.61 / $8,317.64	Facility		$3,090.30	$5,128.61	$8,317.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,454.71 / $3,388.44	Professional		$1,737.80	$2,454.71	$3,388.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,445.44 / $4,466.84	Professional		$1,174.90	$1,445.44	$4,466.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $41,686.94 / $72,443.60	Facility		$3,235.94	$41,686.94	$72,443.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $54,954.09 / $97,723.72	Professional		$4,265.80	$54,954.09	$97,723.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $6,165.95	Facility		$2,290.87	$2,290.87	$6,165.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,466.84	Professional		$4,073.80	$4,073.80	$4,466.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $6,165.95 / $16,982.44	Facility		$2,290.87	$6,165.95	$16,982.44
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,168.69	Facility		$4,168.69	$4,168.69	$4,168.69
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $3,715.35 / $6,918.31	Professional		$2,630.27	$3,715.35	$6,918.31
United Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,737.80 / $3,890.45	Professional		$1,230.27	$1,737.80	$3,890.45